Individual provider Active NPI

Kara Maureen Shahrava, FNP-BC

  • Nurse Practitioner
  • Lincolnwood, IL
National Provider Identifier
1861012239
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209019485 Issued in IL
Practice address
6810 N McCormick Blvd
Lincolnwood, IL 60712-2709
Phone
(847) 674-6900
Fax
(847) 329-4728
NPI assigned
Apr 25, 2020
Last updated
Apr 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.019485 IL
Nurse Practitioner 363L00000X 209019485 IL Primary

Addresses

Primary practice location

6810 N McCormick Blvd
Lincolnwood, IL 60712-2709

Mailing address

6810 N McCormick Blvd
Lincolnwood, IL 60712-2709
Phone (847) 674-6900

Other practice location 1

219 W Chicago Ave
Chicago, IL 60654-5600
Phone (312) 878-1945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200522001178 IL Practitioner - Nurse Practitioner 3375964620 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

6810 N McCormick Blvd
Lincolnwood, IL 60712-2709
Phone (847) 674-6900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209019485ILMDNurse Practitioner
209.019485ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Apr 26, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Apr 26, 2022 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Apr 20, 2020 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Apr 20, 2020 Accepting new patients

Locations

12200 Western Ave
Blue Island, IL 60406
Phone (630) 581-5372

219 W Chicago Ave
Chicago, IL 60654
Phone (312) 878-1945

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

6810 N McCormick Blvd
Lincolnwood, IL 60712
Phone (847) 674-6900

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1861012239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 N MCCORMICK BLVD",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122709",
            "telephone_number": "847-674-6900",
            "fax_number": "847-329-4728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 N MCCORMICK BLVD",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122709",
            "telephone_number": "847-674-6900",
            "fax_number": "847-329-4728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 W Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606545600",
            "country_code": "US",
            "telephone_number": "312-878-1945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAHRAVA",
        "first_name": "KARA",
        "middle_name": "MAUREEN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-25",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.019485",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209019485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnwood, IL

Sources for this page

Verify at the official NPI Registry.